a special program of the National Emergency Medicine Association (NEMA)
Transcripts: 516-1 and 516-2
Week: 516.1 Guest: Stanley A. Cohn, V.M.D. Topic: Rabies in Humans - Part One Host: Richard Roeder Producer: Ed Graham
NEMA: Rabies is a disease for which there is no cure once it is contracted by animals or humans. This is the first half of a conversation on rabies in humans. My guest is veterinarian Dr. Stanley Cohn from the Old Trail Animal Hospital in Shrewsbury, Pennsylvania.
NEMA: Dr. Cohn, one of the things people worry about when they think about this topic of rabies is not only their pets being infected with it but the family members being infected with it also. How common is that and how susceptible are humans to getting rabies if their animal has it or has been exposed to it?
COHN: Humans are just as susceptible to rabies as their dogs and cats and they can get rabies from their pets but it would be very very unusual for this to happen since the pets by law have to have rabies vaccines and have to be up to date on rabies vaccines and almost every municipality has these laws but again we don't know where these animals are or when they get into fights, what's going on with them. Routinely, if you know that your dog which is up to date on a rabies vaccination has been in a fight with a raccoon, if you do not have the raccoon, then you take the dog to your veterinarian and usually he'll be examined and given a booster against rabies. If the dog has not been vaccinated or the vaccine is out of date then you have to talk to the health department and determine what their ruling will be. In many of these cases, the animals have to be sacrificed because they represent a risk to humans. If an unprotected animal is bitten by let's say a rabid skunk or a rabid raccoon and no one knows about it, then that dog or that cat, that pet will indeed come down with rabies. It will start to show the signs of rabies and it will end up in a veterinary facility, a veterinary hospital and this is the big risk, the big fear that we all have that you have a small dog or you have a cat that comes in and it is unable to eat and it's been acting kind of strange for a day or two and you've never seen this animal before, it's a brand new animal to your practice and you bring it into the hospital because you can't see what's wrong with it, of course the first thing you do is open the mouth and pull out the tongue to look into the throat to see if there's some kind of an obstruction and the whole hospital can be placed in a very dangerous situation. Health care professionals in our area can get rabies prophylaxis. We can get injections just as you do for dogs and cats to prevent us from getting rabies so if we are in an area where there is a rabid dog or rabid and we are treating it or if you're even cleaning a cage where there has been one of these animals, you are certainly susceptible to it and we try to protect our staff from that kind of problem.
Week: 516.2 Guest: Stanley A. Cohn, V.M.D. Topic: Rabies in Humans - Part Two Host: Richard Roeder Producer: Ed Graham
NEMA: This is the second half of a discussion about rabies and humans. My guest is veterinarian Dr. Stanley Cohn from the Old Trail Animal Hospital in Shrewsbury, Pennsylvania. I asked Dr. Cohn what should be done when someone is bitten by a stray animal.
COHN: Your dog is bitten or you are bitten, then washing the wound thoroughly, cleaning it off, getting rid of the virus that may be there is a very important first step, flushing it away, mechanically getting rid of this kind of thing before it can cause harm to get into your system.
NEMA: I assume that one of the sort of dreaded and famous things that I remember from the past is when some kid in the neighborhood would be bitten by a stray and immediately be taken to a doctor and begin a series of shots that I believe in the old days were administered into the abdomen were sort of famous for their dreadfulness and pain involved or at least the fear involved but nowadays, there is still a treatment regimen for a person who has been bitten but it's not quite as tough on the recipient anymore. Am I correct about that?
COHN: Right. And whether they're given gamma globulin to try to increase the immune reaction of the body to fight off this kind of an infection or whether there is really a whole vaccination series that they go through is nowhere near as bad as it used to be but it's still not a lot of fun. It's really important to find that animal and preserve that animal. Let's say the animal is hit by a car and someone goes up to help this raccoon that's lying on the road that's hit by a car and in trying to put you hand out to it to help it, with fear the animal should bite the person, that animal should be humanely taken care of. The wound should be washed out thoroughly in the person's hand and the animal taken to the health department to be checked for rabies. If you can't get to the health department right away, then the animal should be maintained in a cold box, not frozen, but maintained in a cold area until the next day you take it to the health department and find out immediately whether or not it has rabies. You need the head of the animal. The rest of the animal is going to come along with it but the head, the brain is really has to be sectioned to find out if this animal is carrying rabies and transmitting rabies.
NEMA: In the case when someone has been bitten by an animal that's determined to have been rabid and they're put on the most recent treatments for this to prevent them from getting rabies, how effective are these medications in preventing that from taking place. Are they 100% effective?
COHN: Very effective. Very effective. As long as you're not showing signs of rabies, these vaccines, these treatments to the best of my knowledge are I guess 95% to 100% effective. That would be my guess. I do not know. That's human medicine so I can't give you that but you just don't hear, thank God, of that many people in this area who acquire rabies.